Cognitive Legacy of Famine: Long-Term Academic Effects of Early-Life Malnutrition in Ghana’s 1983 Cohort

Abstract Background The long-term academic consequences of early-life malnutrition remain underexplored in sub-Saharan Africa, particularly regarding survivors of the 1983 famine in Ghana. While existing studies link early nutritional deprivation to developmental delays, little is known about its lasting impact on educational attainment and cognitive functioning in adulthood. This study investigates the cognitive and academic outcomes of individuals born during the 1983 famine, shedding light on the intergenerational legacy of malnutrition. Methods Using a phenomenological retrospective cohort design, this qualitative study explored the lived experiences of 30 participants—15 adults born during the 1983 famine and their 15 biological mothers. Participants were purposively selected from famine-affected rural and peri-urban communities in Ghana’s Northern, Bono East, and Central Regions. Data were collected through semi-structured, in-depth interviews and analyzed using reflexive thematic analysis. The study was guided by an integrated conceptual framework comprising the Developmental Origins of Health and Disease (DOHaD) theory, Bronfenbrenner’s Socio-Ecological Theory, Social Cognitive Career Theory (SCCT), and Resiliency Theory. Results Four major themes emerged: (1) neurocognitive impairments and delayed school enrolment, (2) psychosocial barriers to academic engagement, (3) disrupted parental investment in education, and (4) the role of resilience and social support systems. Participants consistently reported challenges with memory, attention, and academic progression, often exacerbated by household poverty and social stigma. However, several individuals demonstrated post-adversity resilience mediated by strong maternal bonds, religious coping, and external support from NGOs and community actors. Conclusion This study provides novel empirical insights into the cognitive and educational legacy of famine in Ghana. Early-life malnutrition was found to exert enduring biological and educational effects that were further shaped by social environments, personal agency, and adaptive resources. The findings underscore the importance of contextually sensitive, long-term interventions targeting the educational and psychosocial recovery of populations affected by early-life deprivation. Policies addressing intergenerational poverty, nutrition, and cognitive support are critical to mitigating the long-term consequences of developmental shocks in low-resource settings.